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Objective: To compare measurements of internal size of patent ductus arteriosus on transthoracic echocardiography with angiography, serving as the gold standard, in infants and children. Methods: Retrospective analysis of data from paediatric patients undergoing transcatheter patent ductus arteriosus device closure in a tertiary paediatric cardiac centre between March 2013 and March 2014 was performed. Internal size measurements of patent ductus arteriosus were performed retrospectively on recorded echocardiographic and angiographic images independently on 2 separate occasions by two observers on a mutually agreed image. Results: In total 47 patients with available adequate echocardiographic and angiographic images were identified. Median age of patients was 7.5 years (range 8 months - 15 years) and average weight was 12.5 kg (SD 7.5 kg). Intra-observer correlation coefficient was 0.5 (95% confidence interval 0.25-0.69) and inter-observer correlation coefficient was 0.45 (95% confidence interval 0.18-0.65) for echocardiographic measurements and 0.75 (95% confidence interval 0.61-0.85) and 0.83 (95% confidence interval 0.71-0.9) for angiographic measurements, respectively. The Pearson's correlation coefficient was 0.275 and interclass correlation coefficient was 0.247 between echocardiographic and angiographic measurements of ductal internal size, by a single observer, suggesting poor correlation and agreement. The measurements of the same duct by the same observer from echocardiogram and angiogram were significantly different (p<0.0001). Conclusion: Based on our data, angiographic measurement considered the gold standard for assessment of patent arterial ductal size does not correlate well with echocardiographic measurements. This may have implications for treatment strategies based on echocardiographic ductal size measurements only. [ABSTRACT FROM AUTHOR]